It is well known to use surgical cable and crimp assemblies to fix parts of a fractured bone and to join them together until the bone heals. Surgical procedures on and in the vicinity of a bone with closely neighboring nerves, arteries, muscle, ligaments, complicated anatomical structures and delicate areas represent a difficult and time consuming task for the surgeon. Thus it is important for the cable and crimp device to be assembled accurately, minimizing stress, trauma, risk, and injury to a patient while facilitating and shortening the procedure.
Furthermore it is desirable to maintain the bulk of the cable as well as the joint where the cable is affixed to itself as compact as possible to minimize discomfort and damage to the surrounding tissue.
Known minimally invasive techniques for such procedures generally involve looping the cable, isolated from the crimp member, about the bone and then inserting a beaded first end of the cable into a cavity of a groove in the crimp member. The groove at the crimp member allows the first end of the cable to slide in place until the bead locks in its final position. The second end of the cable is then inserted through the hole of the crimp member and the cable is tensioned by application of a tensioning tool to the cable through a handle, to a proximal abutment face of the crimp. Once the desired final tension has been established, the set screw is tightened using a screwdriver through the handle, deforming the cable inside the hole. The tensioning tool is then removed and the free end of the cable extending from the proximal abutment face of the crimp is cut off.
Many of the known tools for performing this procedure require pulling the cable from both ends after the cable has been looped around the bone. To access both ends of the cable as required, such devices require significant spreading of the incision and the tissue along the path of the cable increasing trauma to muscle and other surrounding tissue and making them unsuitable for use in restricted areas. Such devices are disclosed, for example, in U.S. Pat. Nos. 5,649,927 and 6,017,347.
Other devices such as that described in allow tensioning of the cable by application of a tensioning tool to one of the cable ends and to an abutment face of the crimp by employing a surgical cable factory crimped to one of the holes of the crimp, as those disclosed in U.S. Pat. Nos. 5,423,820, 6,007,268 and 6,387,099. The same effect is achieved by instruments such as that described in U.S. Pat. No. 6,017,347, that use a wire with a beaded end which locks into an end of the crimp preventing the wire from slipping out of the clamp. The bead locks into the end of the crimp preventing the wire from sliding out of the crimp.